Provider Demographics
NPI:1447961453
Name:AMAZING KIDDOS WORLD BEHAVIORAL SERVICES CORP
Entity type:Organization
Organization Name:AMAZING KIDDOS WORLD BEHAVIORAL SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRETONES
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:954-862-1409
Mailing Address - Street 1:12555 ORANGE DR STE 274
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-4304
Mailing Address - Country:US
Mailing Address - Phone:954-862-1409
Mailing Address - Fax:
Practice Address - Street 1:12555 ORANGE DR STE 274
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330-4304
Practice Address - Country:US
Practice Address - Phone:954-862-1409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty